﻿<%@ Page Language="C#" AutoEventWireup="true" CodeFile="Defaulaat.aspx.cs" Inherits="Claims_Defaulaat" %>

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">

<html xmlns="http://www.w3.org/1999/xhtml">
<head runat="server">
    <title></title>
    <style type="text/css">
        .style1
        {
            height: 59px;
        }
        .style2
        {
            height: 7px;
        }
        .style3
        {
        }
    </style>
</head>
<body>
    <form id="form1" runat="server">
    <table border="2" class="style1" width="750px">
        <tr>
            <td style="margin: 20px; font-size: large; font-weight: bold; clip: rect(-2px, auto, auto, auto);">
                <asp:Label ID="Label1" runat="server" Text="Label"></asp:Label>
            </td>
            <td style="margin: 20px; font-size: large; font-weight: bold; clip: rect(-2px, auto, auto, auto);" 
                width="30%">
                &nbsp;</td>
            <td colspan="2" 
                style="padding: 20px; margin: 20px; font-size: x-large; font-weight: bold; clip: rect(-2px, auto, auto, auto);">
                CLAIM NOTE</td>
            <td style="padding: 20px; margin: 20px; font-size: large; font-weight: bold; clip: rect(-2px, auto, auto, auto);">
                &nbsp;</td>
        </tr>
        <tr>
            <td>
                &nbsp;</td>
            <td>
                &nbsp;</td>
            <td style="padding: 20px">
                <span style="font-weight:bold;">Date</span><br />
                <asp:Label ID="Label3" runat="server" Text="Label"></asp:Label>
            </td>
            <td style="padding: 20px">
                Claim no<br />
                <asp:Label ID="Label4" runat="server" Text="Label"></asp:Label>
            </td>
            <td class="style3" 
                style="padding: 20px; font-weight: normal; font-size: large;">
                Supplier<br />
                <asp:Label ID="Label6" runat="server" Text="Label"></asp:Label>
            </td>
        </tr>
        <tr>
            <td>
                &nbsp;</td>
            <td>
                &nbsp;</td>
            <td colspan="2" style="padding: 20px;">
                Out reference<br />
                <asp:Label ID="Label5" runat="server" Text="Label"></asp:Label>
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td>
                &nbsp;</td>
            <td>
                &nbsp;</td>
            <td colspan="2" width="30%">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td colspan="5">
                &nbsp;</td>
        </tr>
    </table>
    </form>
</body>
</html>
